Abstract：
Differentiating depression in major depressive disorder and bipolar disorder is challenging in clinical practice. Therefore, reliable biomarkers are urgently needed to differentiate between these diseases. This study\'s main objective was to assess whether cardiac autonomic function can distinguish patients with unipolar depression (UD), bipolar depression (BD), and bipolar mania (BM).
We recruited 791 patients with mood disorders, including 191 with UD, 286 with BD, and 314 with BM, who had been drug free for at least 2 weeks. Cardiovascular status was measured using heart rate variability (HRV) and pulse wave velocity (PWV) indicators via finger photoplethysmography during a 5-min rest period.
Patients with BD showed lower HRV but higher heart rates than those with UD and BM. The PWV indicators were lower in the UD group than in the bipolar disorder group. The covariates of age, sex, and body mass index affected the cardiovascular characteristics. After adjusting for covariates, the HRV and PWV variations among the three groups remained significant. Comparisons between the UD and BD groups showed that the variable with the largest effect size was the frequency-domain indices of HRV, very low and high frequency, followed by heart rate. The area under the receiver operating characteristic curve (AUC) for each cardiovascular variable ranged from 0.661 to 0.714. The High-frequency index reached the highest AUC.
Cross-sectional design and the magnitude of heterogeneity across participants with mood disorders limited our findings.
Patients with BD, but not BM, had a greater extent of cardiac imbalance than those with UD. Thus, HRV may serve as a psychophysiological biomarker for the differential diagnosis of UD and BD.
We recruited 791 patients with mood disorders, including 191 with UD, 286 with BD, and 314 with BM, who had been drug free for at least 2 weeks. Cardiovascular status was measured using heart rate variability (HRV) and pulse wave velocity (PWV) indicators via finger photoplethysmography during a 5-min rest period.
Patients with BD showed lower HRV but higher heart rates than those with UD and BM. The PWV indicators were lower in the UD group than in the bipolar disorder group. The covariates of age, sex, and body mass index affected the cardiovascular characteristics. After adjusting for covariates, the HRV and PWV variations among the three groups remained significant. Comparisons between the UD and BD groups showed that the variable with the largest effect size was the frequency-domain indices of HRV, very low and high frequency, followed by heart rate. The area under the receiver operating characteristic curve (AUC) for each cardiovascular variable ranged from 0.661 to 0.714. The High-frequency index reached the highest AUC.
Cross-sectional design and the magnitude of heterogeneity across participants with mood disorders limited our findings.
Patients with BD, but not BM, had a greater extent of cardiac imbalance than those with UD. Thus, HRV may serve as a psychophysiological biomarker for the differential diagnosis of UD and BD.
摘要：
背景：在临床实践中，将抑郁症与重性抑郁障碍和双相情感障碍区分开来具有挑战性。因此,迫切需要可靠的生物标志物来区分这些疾病.这项研究的主要目的是评估心脏自主神经功能是否可以区分单相抑郁症（UD）患者，双相抑郁（BD），和双相躁狂症（BM）。
方法：我们招募了791名情绪障碍患者，包括191个UD，286带BD,和314与BM，至少2周没有吸毒。在5分钟的休息期间，通过手指光电容积描记术使用心率变异性（HRV）和脉搏波速度（PWV）指标测量心血管状态。
结果：与UD和BM患者相比，BD患者的HRV较低，但心率较高。UD组的PWV指标低于双相障碍组。年龄的协变量，性别,体重指数影响心血管特征。在调整协变量后，三组间的HRV和PWV差异仍然显著.UD和BD组之间的比较表明，具有最大效应大小的变量是HRV的频域指数，非常低和高频率，其次是心率。每个心血管变量的受试者工作特征曲线下面积（AUC）范围为0.661至0.714。高频指数达到最高AUC。
结论：横断面设计和情绪障碍参与者的异质性程度限制了我们的研究结果。
结论：BD患者，但不是BM，与UD患者相比，心脏失衡程度更大。因此，HRV可作为UD和BD鉴别诊断的心理生理生物标志物。
方法：我们招募了791名情绪障碍患者，包括191个UD，286带BD,和314与BM，至少2周没有吸毒。在5分钟的休息期间，通过手指光电容积描记术使用心率变异性（HRV）和脉搏波速度（PWV）指标测量心血管状态。
结果：与UD和BM患者相比，BD患者的HRV较低，但心率较高。UD组的PWV指标低于双相障碍组。年龄的协变量，性别,体重指数影响心血管特征。在调整协变量后，三组间的HRV和PWV差异仍然显著.UD和BD组之间的比较表明，具有最大效应大小的变量是HRV的频域指数，非常低和高频率，其次是心率。每个心血管变量的受试者工作特征曲线下面积（AUC）范围为0.661至0.714。高频指数达到最高AUC。
结论：横断面设计和情绪障碍参与者的异质性程度限制了我们的研究结果。
结论：BD患者，但不是BM，与UD患者相比，心脏失衡程度更大。因此，HRV可作为UD和BD鉴别诊断的心理生理生物标志物。
